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Indian J Med Microbiol. 2019 Jan-Mar;37(1):123-126. doi: 10.4103/ijmm.IJMM_19_213.

Knee and the farm animals: An unusual presentation of Brucella melitensis masquerading as tuberculosis.

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Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi, India.
Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India.


In many developed countries, brucellosis has been successfully eradicated. However, brucellosis, with its myriad presentations, continues to be a clinical and diagnostic challenge in primarily agrarian countries such as India. We present a case of a rare manifestation of brucellosis i.e., septic arthritis of the knee joint associated with a lytic lesion of the proximal tibia. The patient belonged to a Brucella endemic country, and clinical features were of chronic reactive knee arthritis with synovial hypertrophy and effusion. Advanced diagnostic methods played a pivotal role in excluding the diagnosis of tuberculosis, and thus unnecessary administration of antitubercular therapy and initiating focused narrowed anti-Brucella management, achieving the goal of antimicrobial stewardship also.


Antimicrobial stewardship; Brucella melitensis; brucellosis; knee; lytic lesion; septic arthritis; synovial hypertrophy

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